For some patients, co-pays, office visits, procedures and medications may be unaffordable and/or a hardship. Insurance companies pay lesser fees for all services than a private patient will. There is almost always room for negotiation -- one just need a stragegy. "With patients paying more out of pocket for their health care than ever before — in the form of higher co-payments and co-insurance, high deductibles and uncovered and out-of-network treatments — negotiating with doctors and other providers has become commonplace. But how exactly should you approach these nerve-racking discussions? See this NY Times article for starters: A Talk With the Doctor May Help Patients Afford Care.